Queens New York Revocación de autorización para usar o divulgar información de salud protegida - Revocation of Authorization To Use or Disclose Protected Health Information

State:
Multi-State
County:
Queens
Control #:
US-3579
Format:
Word
Instant download

Description

Revocation of Authorization To Use or Disclose Protected Health Information Para su conveniencia, debajo del texto en español le brindamos la versión completa de este formulario en inglés. For your convenience, the complete English version of this form is attached below the Spanish version.
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Queens New York Revocación de autorización para usar o divulgar información de salud protegida